OBJECTIVE To investigate the incidence and trends of nosocomial infections of preterm infants in NICU and to explore their risk factors and strategies of infection control.METHODS A study was made among 1 026 hospitalized preterm infants from Jan 1992 to Dec 2004.RESULTS There were 316 times nosocomial infections in 266 preterm infants.Cumulative incidence rate for nosocomial infection was 25.9 neonates out of 100 admissions.The incidence density was 18.6 infections per 1000 patient days.The high risk factors for nosocomial infections included the parenteral nutrition,birth weight ≤1 500 g and mechanical ventilation(P

Objective Through the analysis of misdiagnosis left renal vein entrapment syndrome,to improve the understanding and reduce the misdiagnosis of this disease.Methods 82 cases of left renal vein compression syn-drome were diagnosed with ultrasound,65 cases were misdiagnosed.Clinical data of these 65 patients were analyzed.Results In 82 cases,only 11 doctors from renal department of internal medicine,pediatrics,department of urology wrote application for it.Among the 65 misdiagnosed cases,30 cases of male,female 35 cases.The age ranged from 6 to 37 years old,the average age was 16.1 years.The misdiagnosis duration ranged from 2 months to 42 months,the median time was 7 months.43 cases of low back pain or backache,urinary tract irritation in 5 cases,60 cases of abnor-mal urinalysis:a simple urinary protein in 15 cases,21 cases of simple hematuria,proteinuria,hematuria 24 cases. 31 cases were misdiagnosed as chronic glomerulonephritis,occult nephritis(asymptomatic proteinuria and hematuria syndrome)in 11 cases,acute nephritis comprehensive sign in 9 cases,7 cases of lumbar muscle strain,urinary tract infection in 4 cases,1 case of urinary tract stones,pelvic inflammatory disease in 2 cases.In the 16 cases complicated with glomerular nephritis,were treated as the glomerular nephritis before (11 cases of chronic nephritis,5 cases of asymptomatic proteinuria and hematuria syndrome).12 cases of abnormal urine fluctuation,after a delay of 3 -16 months referral doctor was diagnosed with left renal vein entrapment syndrome.Conclusion The disease has no char-acteristic clinical manifestations,and most clinicians were short in understanding of the disease,so the misdiagnosis rate is high.The clinicians should improve the understanding of the disease,in order to reduce the misdiagnosis rate.

Objective To study the clinicopathological characteristics and immunophenotype of solid pseudopapillary neoplasm (SPN) of the pancreas.Methods Retrospective analysis was performed for the clinical materials,pathological features and immunohistochemical phenotype characteristics of the 23 SPN cases.Results Ratio of male to female was 1:10;the average age was 32 years.10(43％) patients had no clinical symptoms,12 (52％) patients had abdominal pain,abdominal distention or diarrhea;1 patient had jaundice.Tumors were in the head of pancreas in 10(43％) cases,and were in the tail or body of pancreas in 13 cases.Grossly,tumors were solid-cystic or solid;the maximum diameter were from 1.3 cm to 17 cm,with the average of 5.9 cm;12 (52％) cases appeared encapsulated.Histopathologically,21 (91％) cases appeared to exhibit a fibrous capsule surrounding the tumors,and the fibrous capsule invasion were observed in all these cases;Pancreas tissues were involved in 8(35％) cases.Tumor cells arranged in sheets,nests and pseudopapillary patterns.Hemorrhage,necrosis and cystic degeneration were often seen.Tumor cells were positive for vimentin,β-catenin,CK,CD10,PR,CD56 and Syn.Tumor were mostly negative for CgA and Ki-67.23 cases were followed up for 2 to 44 months,and all were alive.Conclusion SPN is a low degree malignant tumor often seen in young women with various histological patterns and multiple immunophenotypes.Definite diagnosis of SPN can be made by combining clinicopathological characteristics with a panel of immunohistochemicat marks.SPN grows slowly,often responds to surgical resection and rarely recur.

Objective To investigate the relationship of angiotensin converting enzyme (ACE I/D) gene I/D polymorphism with vitiligo.Methods PubMed,the Cochrane Library,China academic journal full-text database and VIP database and Wan fang database were searched according to the inclusion and exclusion criteria,and the quality of included studies was assessed.The data were quantitatively analyzed by Stata 12.0 software.Results Nine articles were included.Meta analysis results showed that the susceptibility of vitiligo difference was statistically significant in the total population of ACE I/D genotype (DD + II)vs.DI (OR=0.759,95％ CI:0.643 ～0.896,P=0.001),the (DD+DI) vs.II (OR=1.523,95％ CI:1.153 ～2.011,P =0.003).The genotype subgroup analysis showed the D vs.I (OR =1.381,95％ CI:1.054 ～1.810,P=0.019),DDvs.II (OR=1.830,95％ CI:1.110～3.017,P=0.018),(DD+ II) vs.DI (OR=0.814,95％ CI:0.667 ～0.994,P=0.043),and the (DD+ID) vs.II (OR=1.690,95％ CI:1.147 ～2.489,P =0.008) in Asian.The difference was statistically significantly related to vitiligo.Arab genotype (DD + II) vs.DI (OR =0.545,95％ CI:0.354 ～ 0.840,P =0.006) was associated with vitiligo occurrence.Begg's inspection publication bias analysis showed all genetic types did not exist any publication bias.Conclusions The ACE gene I/D polymorphism may be associated with vitiligo susceptibility.

Objective:To assess the changing trends in Gleason score (GS)of Chinese prostate carci-noma (PCa)from January 1995 to December 2014.Methods:In the study,875 patients admitted to hospital from January 1995 to December 2004 (1995 -2004)and from January 2005 to December 2014 (2005 -2014)were divided into two groups.The mean levels and proportions of GS,primary and se-condary grades were studied.The patients were divided into four groups according to age: <60,60 -69,70 -79 and ≥80 years.Types of specimen included needle biopsy (NB),transurethral resection of the prostate (TURP)and radical prostatectomy (RP).Histological types were made up by acinar carci-noma and other types (including atrophic,pseudohyperplastic,foam,signet ring cell and ductal carcino-ma,and so on).The total prostate-specific antigen (tPSA)involved groups of <20.0 μg/L and ≥20.0 μg/L.We observed the mean levels and proportions of GS in age,types of specimen,histological types and total prostate-specific antigen in different periods,and used SPSS 17.0 software for statistical analysis.Results:Compared with 1995 -2004,the mean levels of GS,primary and secondary grades decreased 0.32 (P =0.003),0.19 (P =0.001)and 0.12 (P =0.016)in 2005 -2014,respectively. The proportions of ≤6 in GS increased 10.9% (P =0.003),and ≥8 decreased 14.0% (P <0.001). The difference of GS 7 was not statistically significant.In the primary grade,the ratio of grades≤3 in-creased 12.8% (P =0.001 ),and grade 4 decreased 7.4% (P =0.037),grade 5 decreased 5.5%(P =0.007).The ratio of secondary grades≤3 increased 7.6% (P =0.037).The difference of grades 4 and 5 was not statistically significant.Conclusion:GS in Chinese patients with PCa showed a down-ward trend,which is one of the notable features in the past 20 years in China.The types of specimen and age are important factors in GS,while the histological types and tPSA have less impact on the GS.

Objective To investigate the prevalence of Alzheimer's disease (AD) in first-degree relatives of patients with affective disorders,and to evaluate the risk of AD in first-degree relatives of the patients with affective disorders.Methods Patients with affective disorders meeting DSM-Ⅳ-TR criteria (affective disorders group) and their healthy spouses (conrol group) were recruited in this study (n=109 each).The first-degree relatives inclusion criteria were biological relatives of both probands aged over 55 years.Subjects were investigated by neuropsychological assessment,imaging and clinical examinations,and were diagnosed as AD according to the criteria of the United States of America neuropathy language disorders and stroke research institute and Alzheimer's disease and Related Disorders Association (NINCDS-ADRDA).Results 284 first-degree biological relatives of affective disorders patients and 274 first-degree relatives of control group were selected.There were no statistically significant differences in demographic characteristics of the first-degree relatives between the two groups.The prevalence of Alzheimer's disease in the first-degree relatives had a significant difference between affective disorders group and control group [10.6％ (30/284) vs.4.4％ (12/ 274),x2=7.47,P=0.006].The prevalence of AD in the first-degree relatives was higher in bipolar disorder and depressive disorder patients than in control group [11.2％ (14/125) vs.4.4％(12/274),20.0％ (15/75) vs.4.4％(12/274),x2=6.80,20.56,OR=2.60,4.63,both P＜0.05],while there was no significant difference in the prevalence of AD in the first-degree relatives between mania patients and control group [1.1％ (1/87) vs.4.4％ (12/274),x2 =1.99,P＞0.05].Conclusions There is a high risk for Alzheimer' s disease in first-degree relatives of patients with affective disorders,particularly in first-degree relatives of patients with depression and bipolar disorders.

Objective To elucidate the genome organization of small deletion mutants of hepatitis B virus(HBV).Methods Amplified the HBV genomes by polymerase chain reaction from the serum of the patients with chronic hepatitis B and cloned the small HBV DNA less than 1 kb,then sequenced and analyzed the gene organization of these small deletion mutants of HBV.Results Totally one hundred and twenty-four small deletion mutants of HBV genomes categorized to sixty-four types were obtained and classified into three groups according to the criteria of the characteristics of gene organization,for example,spliced variants,regular deletion mutants and the deletion mutants with an internal poly (dA).All of these isolated mutants shared some common features as the deletion in coding regions and regulatory elements,66% of the mutants retained the cis elements crucial for the viral replication and encapsidation,while 48% retained the X region.Conclusions Small deletion mutants of HBV are commonly detected in the serum from chronic hepatitis B patients,the characteristic structure of such mutants implies that they might be closely co-related with the pathogenicity of HBV.The exact mechanisms need further study yet.

Objective To explore the time of application of hemoperfusion (HP) for the treatment of acute serious organophosphorus pesticide (ASOPP). Methods One hundred and four patients with ASOPP were randomly divided into two groups, 46 patients accepted traditional treatment(control group), 58 patients were treated with traditional treatment and HP (HP group). The patients in HP group were again divided into three groups according the different time of treatment (time of beginning HP after poisoning), the 4-8 hours group (HP-1 group, 27 patients), the 9-16 hours group (HP-2 group, 19 patients), the 17-32 hours group (HP-3 group, 12 pafients).Tbe coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality and curing among groups were observed. Results The coma period, the dosage of atropine, the time of regaining the vitality of cholinesterase, the time of hospitalization and the rate of fatality of the HP group were less than those of the control group (P<0.05). Compared with HP-1 group, the eoma period, the dosage of atropine, the time of regaining the vitality of eholinesterase and the time of hospitalization of the HP-2 group and the HP-3 group were higher (P<0.05), but the difference of the rate of fatality and curing between the HP-1 group and the other HP groups was not statistically significant (P>0.05). The difference of all of the above indicators between HP-2 group and HP-3 group was not statistically significant (P>0.05). Conclusion Application of hemoperfusion among 4-32 hours after poisoning for the treatment of ASOPP can improve the efficacy of therapy, and the efficacy of application of hemoperfusion among 4-8 hours is the best.

Objective To investigate the anti-IFN-α effects of the novel protein TSR'r' encodedby the 458 nt-1308 nt spliced variant of hepatitis B virus genome,and to determine its functional domaias.Methods the TSR'r' gene(originated from open reading frame of HBV DNA polymerase,T represents terminal protein region,S represents the Spacer region,R'represents the truncated reverse transcriptase region,and r'represents the truncated RNaseH region)of the 458 nt-1308 nt spliced variant of HBV genome and its deletants were amplified by PCR and were cloned into the pcDNA3.1/HisC vector.The recombinant vector was transfected into Huh7 hepatocytes individually by FuGENE6 transfection reagent,and the expression of the fusion protein was detected by Western blot.Huh7 hepatocytes were co-transfected with p6 16CAT and the recombinant vector harboring either TSR'r'or the related deletant,and treated with IFN-α 2a 48 h post transfection.After 24 h stimulating.the cells were lysed and the intracellular CAT value was calculated.All data were processed with One-way analysis of variance(ANOVA).Resuits Recombinant vectors harboring either the TSR'r'gene or related deletant were constructed successfully,and the fusion proteins were expressed well in Huh7 cells.When Huh7 hepatocytes were co-transfected with p6-16CAT and TSR'r' recombinant.the intracellular CAT values reduced gradually as paralleled with the increasing amount of TSR'r'recombinant.Furthermore,as compared with the empty vector,intracellular CAT values also decreased significantly when the Huh7 cells co-transfected with recombinant harboring TP plus Spacer regions,while any of the other deletants(harboring either TP or Spacer region or neither)showed no significant difference.Conclusion The novel protein encoded by the 458 nt-1308 nt spliced variant of hepatitis B virns genome suppressed the response of Huh7 hepatocytes to IFN-α.and the N-terminal TP plus Spacer region was the functional domain of the protein for anti-IFN-α effects.

Objective:To evaluate the protective effect of Diclipterachinensis polysaccharide P2B on liver cell line L-02 injury in-duced by carbon tetrachloride ( CCl4 ) . Methods:The human liver L-02 cells were cultured, and the injury model was built by CCl4 . The L-02 cells were divided into the normal control group, the CCl4-damaged group, and the P2B sample groups (0. 125, 0. 250 and 0. 500 mg· ml-1 ). The contents of alanine aminotransferase ( ALT), aspartate aminotransferase ( AST), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by MTT assay. Results:Compared with the CCl4-damaged group, P2B could improve the activity of L-02 cells, and the activity of AST and ALT in the supernatant was significantly reduced, and the content of SOD in the cells was increased and that of MDA was decreased. Conclusion:P2B can significantly prevent L-02 cells from the damage induced by CCl4 in a dose-dependent manner, and the mechanism may be related with the anti-oxidative activity of P2B.